P1631: PLATELET DYSFUNCTION DISORDERS; EMERGING COMPLICATIONS OF INFLAMMATORY BOWEL DISEASES
Authors: A. Abomhya, L. Attal, R. Garcia Sturgill, A. Frondella
Journal: HemaSphere (2022)

Background: Apart from platelets’ role in homeostasis, they have pro-inflammatory functions and play a significant role in mucosal healing. Inflammatory bowel diseases (IBD) have been associated with Qualitative and quantitative platelet disorders. Aims: While reactive thrombocytosis is an established feature of IBD flares, few studies investigated the association between IBD and platelet dysfunction disorders. We aimed to estimate the prevalence of platelet dysfunction disorders in patients with IBD. Secondary outcomes included mortality, length of stay, all-cause 30-day non-elective readmission rate, and total cost of hospitalization. Methods: This is a retrospective cohort study. We queried the Nationwide Readmission Databases 2016-2018 using ICD-10-CM codes to identify all adult patients admitted for IBD. Patients with missing information and duplicate admission records were excluded. Patients with a comorbid diagnosis of one of the following platelet dysfunction disorders (qualitative platelet defects, Purpura, primary or secondary thrombocytopenia, and unspecified thrombocytopenia) were identified. The case selection process is summarized in Figure 1. Median and IQR were used to describe Continuous variables, and proportions were used with categorical variables. Before comparing IBD patients with and without platelet dysfunction disorders, we first excluded those with Thrombocythemia. Comparison between groups was performed by Mann Whitney test for continuous variables and Chi-Square test for Categorical variables. Multivariate regression analysis was performed to study the impact of platelet dysfunction disorders on inpatient mortality and non-elective readmissions. Statistical analyses were performed using SPSS Version 25 (IBM Corporation, Armonk, NY, USA). Results: We extracted 365,152 index hospitalization records for IBD, 15,434 (4.3%) had a platelet dysfunction disorder. Platelet dysfunction disorders identified included Allergic purpura (n=85), Qualitative platelet defect (n=62), Immune thrombocytopenic purpura (n=755), other nonthrombocytopenic purpura (n=241), other primary thrombocytopenia (n=45), secondary thrombocytopenia (n=2,541) and unspecified thrombocytopenia (n=11,943). IBD patients with platelet dysfunction disorders were older (64; Interquartile Range (IQR): 51-75 vs. 56; IQR: 38-70, P <0.001), had increased length of stays in days (5; Interquartile Range (IQR): 3-10 vs. 3; IQR: 2-6, P <0.001), increased median total charges ($52,580; IQR: $26,101 - $119,629 vs. $31,965; IQR: $17,580 - $60,540, P <0.001), were more common to have lower GI bleeding (9.2% vs. 8.2%, P <0.001) and more common to require a blood transfusion during hospitalization (15% vs. 5.4%, P <0.001) compared to IBD patients without platelet dysfunction disorders, respectively. On multivariate analysis; having a platelet dysfunction disorder was associated with higher odds of inpatient mortality (Odds ratio (OR): 2.97; 95% confidence interval (CI): 2.75-3.2, P <0.001). and higher odds of all-cause 30-day non-elective readmission (OR: 1.19; 95% CI: 1.12-1.26, P <0.001). Image:Summary/Conclusion: Platelet dysfunction disorders are emerging extraintestinal manifestations of IBD and are associated with worse hospitalization outcomes in this patient population. Revealing the burden of platelet disorders in patients with IBD might incite new research studies to investigate the implications of platelet disorders in IBD outcomes and potential novel targets for therapy.